This article will explain how to split a claim when there are multiple service lines on a claim and insurance does not pay on all of the service lines and the unpaid service line(s) to be rebilled.

Example Claim

1. In Remittance Posting, pull up the claim.
2. Click on the service line that has been denied or not processed.
3. Right Click
4. Select Marked Denied - Resubmit

5. This will mark the service line with a ‘R’ and gray out the paid and write-off column.  You will be able to add the EOB reason code for the denial.  The remaining balance does not go to the patient and there is no insurance payment posted to the line item(s) that have marked as denied to resubmit.
6. Continue posting the rest of the insurance payment normally.

7. Once you have applied to payment, go to Claims Management
8. Go to Underpaid/Denied
9. Find the claim that you marked denied.  Note that paid service line(s) are marked as paid and the denied line(s) is marked as ‘Denied’.

10. In this example, the service line 99213 was denied as being included in other paid services because I did not bill with a  -25 modifier.
11. Highlight the claim and right click
12. Select Go To
13. Select Patient Ledger

14. Find the service line to be corrected, highlight the service line and right click.
15. Select Edit Transaction
16. In this example, I am adding the -25 modifier.
17. Click Save

18.  Go Back to Claims Management
19. Highlight the claim and right click
20. Select ‘Requeue Unpaid Service Lines’ then ‘Edit & Send to Queue’

21. Make any necessary notes related to the rebilling of the claim.
22. When the Modify Claim box appears, select the yellow square to update the claim from the changes made in the database.

23. Click Save
24. PracticeStudio will split the unpaid service line(s) to a claim and the paid line item(s) to another claim (still marked as paid). 
25. The unpaid service line(s) claim will be in Queued Claims ready to be submitted with the modifications made.